Evaluation of microleakage of silorane and methacrylate based composite materials … Alshetili MS et al Received: 10th April 2015 Accepted: 09th July 2015 Conflicts of Interest: None Source of Support: Nil
Journal of International Oral Health 2015; 7(Suppl 2):6-9
Original Research
Evaluation of Microleakage of Silorane and Methacrylate Based Composite Materials in Class I Restorations by Using Two Different Bonding Techniques Mohsen S Alshetili1, Sultan S Aldeyab2
Contributors: 1 Specialist, Department of Conservative Dentistry, East Riyadh Specialized Dental Centre, Ministry of Health, Riyadh, Saudi Arabia; 2Consultant, Department of Restorative Dentistry, King Abdulaziz Medical City, Riyadh, Saudi Arabia Correspondence: Alshetili MS. Department of Conservative Dentistry, East Riyadh Specialized Dental Centre, Ministry of Health, Riyadh, Saudi Arabia. Phone: +966-542222421, Fax: +966-14227914, Email: [email protected] How to cite the article: Alshetili MS, Aldeyab SS. Evaluation of microleakage of silorane and methacrylate based composite materials in Class I restorations by using two different bonding techniques. J Int Oral Health 2015; 7(Suppl 2):6-9. Abstract: Background: To evaluate the microleakage of silorane-based composite material (Filtek P90) with that of two homologous methacrylate-based composites materials (Filtek Z250 and Filtek Z250 XT), by using two different bonding techniques. Materials and Methods: Sixty extracted human maxillary first premolars prepared for standardized Class I cavities (4 mm × 2 mm × 2 mm) were randomly divided into three groups. Group A (n = 20) was filled with Filtek Z250 (Methacrylate) using single bond universal total etching technique, Group B (n = 20) was filled with Filtek Z250 XT (Methacrylate) using single bond universal self-etching technique and Group C (n = 20) restored with Filtek P90 (Silorane) with dedicated two-step self-etching prime and bond adhesive system (P90 system adhesive). Teeth were subjected to thermocycling regime (500×, 5-55°C), and dye penetration by immersing in 2% methylene blue for 24 h. Tooth sectioning was performed, and extent of the dye penetration was scored based on dye penetration scale to evaluate the microleakage. Statistical analysis included descriptive statistics and inferential statistics of Kruskal–Wallis test to compare the mean ranks between groups. Results: There was no significant difference observed for microleakage among the three composite materials tested in the present study. However, the cavities restored with silorane (Filtek P90) based composite displayed higher microleakage than the Filtek Z250, Z250 XT. Conclusion: All the restorative systems tested in this study exhibited microleakage, but the silorane technology showed more microleakage when compared to the methacrylate-based composite systems.
presented with different physical characteristics, colors, and shades. Currently, four types of direct esthetic restorations are commonly used in dentistry which includes - resin composites, poly-acid modified resin composites (copolymer), glassionomers and resin-modified glass-ionomers. Resin composites were introduced in the early 1970s and are widely used as direct esthetic restorations.1 However, composite restorations have several significant disadvantages despite their continuous improvements.2 Despite the fact that composites are currently the most preferred material for restorations, the polymerization shrinkage of 2.6-7.1% prompting microleakage is one of the most often observed issues.3-14 Microleakage is one of major drawbacks of composites which lead to the development of recurrent caries, post-operative sensitivity, enamel fracture, marginal staining, and eventual failure of restorations.4 Studies have reported several ways to decrease this problem such as slowing down the composite polymerization rate, utilizing an incremental build-up technique or placement of low modulus in-between layer, and reducing the C factor (the ratio of bonded to non-bonded restoration surfaces).5 Silorane-based dental resin composite materials introduced to clinical dentistry with an intention to reduce the polymerization shrinkage. Its matrix consists of siloxanes and oxiranes, which differ from the conventional methacrylate (Bis-GMA) composite matrix. Manufactures claimed that the siloranebased composites produce low-polymerization shrinkage of 0.05) (Table 2).
Assumption that microleakage of the cavities restored with the Filtek P90 (silorane) compared to the other resin-based composite materials was due to the innate ringopening polymerization reaction of the silorane monomers, which make-up the volumetric reduction as the molecules approximate each other. However, radical polymerization of the other resin based composites is obvious with a decrease in polymerization shrinkage stresses at the tooth/restoration border. Therefore, methacrylate based composite resins better withstand thermocycling fatigue at the tooth/restoration interface.
Discussion Microleakage of composite restorations occurs because of stresses encountered along the tooth/restoration margin from polymerization shrinkage, temperature variation in the oral environment, and mechanical fatigue through repetitive masticatory loading.15 The most likely cause for this phenomenon is polymerization contraction, which is toward the ‘‘stronger’’ enamel composite joint and the light source.4-10 Various methods to detect microleakage have been suggested including dye leakage method, the use of color producing microorganisms, radioactive isotopes, the air pressure method, neutron activation analysis, electrochemical studies, scanning electron
Our study is in agreement with the study reported by Ernst, who presented no differences in microleakage of teeth restored with silorane and methacrylate composite (Tetric Ceram) with adhesive (Clearfil SE Bond) system.13 This finding was due to the fact that author used an all-in-one (7th generation)
Table 1: Dye penetration test.
Composite materials Filtek Z250 (methacrylate) Filtek Z250 XT (methacrylate) Filtek P90 (silorane)
Mean SD Minimum Maximum 2.10 2.35 2.45
1.07 0.75 0.89
0.00 1.00 1.00
4.00 3.00 3.00
SD: Standard deviation
Table 2: Mean rank as in Kruskal-Wallis test.
Composite material
N Mean Chi‑square df P value rank
Filtek Z250 (methacrylate) Filtek Z250 XT (methacrylate) Filtek P90 (silorane) Total
20 20 20 60
27.30 30.55 33.65
1.597
2
0.450
Graph 1: Distribution of microleakage among different composites (n). 8
Evaluation of microleakage of silorane and methacrylate based composite materials … Alshetili MS et al
experimental bond of silorane before produced by the company. Whereas in the present study new bond produced with silorane composite system consisting of two-step and two components (6th generation) was utilized. However, we disagree with study results of Palin et al., who have reported that the microleakage of silorane based composite material was lesser than that of methacrylate based composite after occlusal loading forces.19-21
Journal of International Oral Health 2015; 7(Suppl 2):6-9
8. Eick JD, Smith RE, Pinzino CS, Kostoryz EL. Stability of silorane dental monomers in aqueous systems. J Dent 2006;34(6):405-10. 9. Palin WM, Fleming GJ, Nathwani H, Burke FJ, Randall RC. In vitro cuspal deflection and microleakage of maxillary premolars restored with novel low-shrink dental composites. Dent Mater 2005;21:95-102. 10. Al-Boni R, Raja OM. Microleakage evaluation of silorane based composite versus methacrylate based composite. J Conserv Dent 2010;13(3):152-5. 11. Basavanna R, Garg A, Kapur R. Evaluation of gingival microleakage of class II resin composite restorations with fiber inserts: An in vitro study. J Conserv Dent 2012;15(2):166-9. 12. Agrawal VS, Parekh VV, Shah NC. Comparative evaluation of microleakage of silorane-based composite and nanohybrid composite with or without polyethylene fiber inserts in class II restorations: an in vitro study. Oper Dent 2012;37(5):E1-7. 13. Ernst CP, Galler P, Willershausen B, Haller B. Marginal integrity of class V restorations: SEM versus dye penetration. Dent Mater 2008;24(3):319-27. 14. Yoshikawa T, Sano H, Burrow MF, Tagami J, Pashley DH. Effects of dentin depth and cavity configuration on bond strength. J Dent Res 1999;78(4):898-905. 15. Kubo S, Yokota H, Sata Y, Hayashi Y. The effect of flexural load cycling on the microleakage of cervical resin composites. Oper Dent 2001;26(5):451-9. 16. Taylor MJ, Lynch E. Microleakage. J Dent 1992;20(1):3-10. 17. Guggenberger R, Weinmann W. Exploring beyond methacrylates. Am J Dent 2000;13:82D-4. 18. Feilzer AJ, De Gee AJ, Davidson CL. Setting stress in composite resin in relation to configuration of the restoration. J Dent Res 1987;66(11):1636-9. 19. Palin WM, Fleming GJ, Nathwani H, Burke FJ, Randall RC. In vitro cuspal deflection and microleakage of maxillary premolars restored with novel low-shrink dental composites. Dent Mater 2005;21(4):324-35. 20. Yamazaki PC, Bedran-Russo AK, Pereira PN, Wsift EJ Jr. Microleakage evaluation of a new low-shrinkage composite restorative material. Oper Dent 2006;31(6):670-6. 21. Bagis YH, Baltacioglu IH, Kahyaogullari S. Comparing microleakage and the layering methods of silorane-based resin composite in wide Class II MOD cavities. Oper Dent 2009;34(5):578-85.
Conclusion Within the limitation of this study, we conclude that all the restorative systems tested in this study exhibited microleakage. However, silorane based technology (Filtek P90) showed higher microleakage scores compared with the clinically successful methacrylate-based composite materials (Filtek Z250 and Filtek Z250 XT). Acknowledgement We would like to thank Professor Mohammad Al-Omari, Chairman, Restorative Department, RCsDP and King Abdullah International Medical Research Center for providing needed help and assistance during the study. References 1. Craig RG, Powers JM, Wataha JC. Dental Materials Properties and Manipulation, 10th ed. St, Louis: Mosby; 2012. 2. Hickel R, Heidemann D, Staehle HJ, Minnig P, Wilson NH, German Scientific Association for Operative Dentistry, European Federation of Conservative Dentistry. Direct composite restorations: Extended use in anterior and posterior situations. Clin Oral Investig 2004;8(2):43-4. 3. Yazici AR, Celik C, Ozgünaltay G. Microleakage of different resin composite types. Quintessence Int 2004;35(10):790-4. 4. Idriss S, Abduljabbar T, Habib C, Omar R. Factors associated with microleakage in Class II resin composite restorations. Oper Dent 2007;32(1):60-6. 5. Krejci I, Sparr D, Lutz F. A three-sited light curing technique for conventional Class II composite resin restorations. Quintessence Int 1987;18(2):125-31. 6. Weinmann W, Thalacker C, Guggenberger R. Siloranes in dental composites. Dent Mater 2005;21(1):68-74. 7. El-Mowafy O, El-Badrawy W, Eltanty A, Abbasi K, Habib N. Gingival microleakage of Class II resin composite restorations with fiber inserts. Oper Dent 2007;32(3):298-305.
9
Journal of International Oral Health 2015; 7(Suppl 2):6-9
Original Research
Evaluation of Microleakage of Silorane and Methacrylate Based Composite Materials in Class I Restorations by Using Two Different Bonding Techniques Mohsen S Alshetili1, Sultan S Aldeyab2
Contributors: 1 Specialist, Department of Conservative Dentistry, East Riyadh Specialized Dental Centre, Ministry of Health, Riyadh, Saudi Arabia; 2Consultant, Department of Restorative Dentistry, King Abdulaziz Medical City, Riyadh, Saudi Arabia Correspondence: Alshetili MS. Department of Conservative Dentistry, East Riyadh Specialized Dental Centre, Ministry of Health, Riyadh, Saudi Arabia. Phone: +966-542222421, Fax: +966-14227914, Email: [email protected] How to cite the article: Alshetili MS, Aldeyab SS. Evaluation of microleakage of silorane and methacrylate based composite materials in Class I restorations by using two different bonding techniques. J Int Oral Health 2015; 7(Suppl 2):6-9. Abstract: Background: To evaluate the microleakage of silorane-based composite material (Filtek P90) with that of two homologous methacrylate-based composites materials (Filtek Z250 and Filtek Z250 XT), by using two different bonding techniques. Materials and Methods: Sixty extracted human maxillary first premolars prepared for standardized Class I cavities (4 mm × 2 mm × 2 mm) were randomly divided into three groups. Group A (n = 20) was filled with Filtek Z250 (Methacrylate) using single bond universal total etching technique, Group B (n = 20) was filled with Filtek Z250 XT (Methacrylate) using single bond universal self-etching technique and Group C (n = 20) restored with Filtek P90 (Silorane) with dedicated two-step self-etching prime and bond adhesive system (P90 system adhesive). Teeth were subjected to thermocycling regime (500×, 5-55°C), and dye penetration by immersing in 2% methylene blue for 24 h. Tooth sectioning was performed, and extent of the dye penetration was scored based on dye penetration scale to evaluate the microleakage. Statistical analysis included descriptive statistics and inferential statistics of Kruskal–Wallis test to compare the mean ranks between groups. Results: There was no significant difference observed for microleakage among the three composite materials tested in the present study. However, the cavities restored with silorane (Filtek P90) based composite displayed higher microleakage than the Filtek Z250, Z250 XT. Conclusion: All the restorative systems tested in this study exhibited microleakage, but the silorane technology showed more microleakage when compared to the methacrylate-based composite systems.
presented with different physical characteristics, colors, and shades. Currently, four types of direct esthetic restorations are commonly used in dentistry which includes - resin composites, poly-acid modified resin composites (copolymer), glassionomers and resin-modified glass-ionomers. Resin composites were introduced in the early 1970s and are widely used as direct esthetic restorations.1 However, composite restorations have several significant disadvantages despite their continuous improvements.2 Despite the fact that composites are currently the most preferred material for restorations, the polymerization shrinkage of 2.6-7.1% prompting microleakage is one of the most often observed issues.3-14 Microleakage is one of major drawbacks of composites which lead to the development of recurrent caries, post-operative sensitivity, enamel fracture, marginal staining, and eventual failure of restorations.4 Studies have reported several ways to decrease this problem such as slowing down the composite polymerization rate, utilizing an incremental build-up technique or placement of low modulus in-between layer, and reducing the C factor (the ratio of bonded to non-bonded restoration surfaces).5 Silorane-based dental resin composite materials introduced to clinical dentistry with an intention to reduce the polymerization shrinkage. Its matrix consists of siloxanes and oxiranes, which differ from the conventional methacrylate (Bis-GMA) composite matrix. Manufactures claimed that the siloranebased composites produce low-polymerization shrinkage of 0.05) (Table 2).
Assumption that microleakage of the cavities restored with the Filtek P90 (silorane) compared to the other resin-based composite materials was due to the innate ringopening polymerization reaction of the silorane monomers, which make-up the volumetric reduction as the molecules approximate each other. However, radical polymerization of the other resin based composites is obvious with a decrease in polymerization shrinkage stresses at the tooth/restoration border. Therefore, methacrylate based composite resins better withstand thermocycling fatigue at the tooth/restoration interface.
Discussion Microleakage of composite restorations occurs because of stresses encountered along the tooth/restoration margin from polymerization shrinkage, temperature variation in the oral environment, and mechanical fatigue through repetitive masticatory loading.15 The most likely cause for this phenomenon is polymerization contraction, which is toward the ‘‘stronger’’ enamel composite joint and the light source.4-10 Various methods to detect microleakage have been suggested including dye leakage method, the use of color producing microorganisms, radioactive isotopes, the air pressure method, neutron activation analysis, electrochemical studies, scanning electron
Our study is in agreement with the study reported by Ernst, who presented no differences in microleakage of teeth restored with silorane and methacrylate composite (Tetric Ceram) with adhesive (Clearfil SE Bond) system.13 This finding was due to the fact that author used an all-in-one (7th generation)
Table 1: Dye penetration test.
Composite materials Filtek Z250 (methacrylate) Filtek Z250 XT (methacrylate) Filtek P90 (silorane)
Mean SD Minimum Maximum 2.10 2.35 2.45
1.07 0.75 0.89
0.00 1.00 1.00
4.00 3.00 3.00
SD: Standard deviation
Table 2: Mean rank as in Kruskal-Wallis test.
Composite material
N Mean Chi‑square df P value rank
Filtek Z250 (methacrylate) Filtek Z250 XT (methacrylate) Filtek P90 (silorane) Total
20 20 20 60
27.30 30.55 33.65
1.597
2
0.450
Graph 1: Distribution of microleakage among different composites (n). 8
Evaluation of microleakage of silorane and methacrylate based composite materials … Alshetili MS et al
experimental bond of silorane before produced by the company. Whereas in the present study new bond produced with silorane composite system consisting of two-step and two components (6th generation) was utilized. However, we disagree with study results of Palin et al., who have reported that the microleakage of silorane based composite material was lesser than that of methacrylate based composite after occlusal loading forces.19-21
Journal of International Oral Health 2015; 7(Suppl 2):6-9
8. Eick JD, Smith RE, Pinzino CS, Kostoryz EL. Stability of silorane dental monomers in aqueous systems. J Dent 2006;34(6):405-10. 9. Palin WM, Fleming GJ, Nathwani H, Burke FJ, Randall RC. In vitro cuspal deflection and microleakage of maxillary premolars restored with novel low-shrink dental composites. Dent Mater 2005;21:95-102. 10. Al-Boni R, Raja OM. Microleakage evaluation of silorane based composite versus methacrylate based composite. J Conserv Dent 2010;13(3):152-5. 11. Basavanna R, Garg A, Kapur R. Evaluation of gingival microleakage of class II resin composite restorations with fiber inserts: An in vitro study. J Conserv Dent 2012;15(2):166-9. 12. Agrawal VS, Parekh VV, Shah NC. Comparative evaluation of microleakage of silorane-based composite and nanohybrid composite with or without polyethylene fiber inserts in class II restorations: an in vitro study. Oper Dent 2012;37(5):E1-7. 13. Ernst CP, Galler P, Willershausen B, Haller B. Marginal integrity of class V restorations: SEM versus dye penetration. Dent Mater 2008;24(3):319-27. 14. Yoshikawa T, Sano H, Burrow MF, Tagami J, Pashley DH. Effects of dentin depth and cavity configuration on bond strength. J Dent Res 1999;78(4):898-905. 15. Kubo S, Yokota H, Sata Y, Hayashi Y. The effect of flexural load cycling on the microleakage of cervical resin composites. Oper Dent 2001;26(5):451-9. 16. Taylor MJ, Lynch E. Microleakage. J Dent 1992;20(1):3-10. 17. Guggenberger R, Weinmann W. Exploring beyond methacrylates. Am J Dent 2000;13:82D-4. 18. Feilzer AJ, De Gee AJ, Davidson CL. Setting stress in composite resin in relation to configuration of the restoration. J Dent Res 1987;66(11):1636-9. 19. Palin WM, Fleming GJ, Nathwani H, Burke FJ, Randall RC. In vitro cuspal deflection and microleakage of maxillary premolars restored with novel low-shrink dental composites. Dent Mater 2005;21(4):324-35. 20. Yamazaki PC, Bedran-Russo AK, Pereira PN, Wsift EJ Jr. Microleakage evaluation of a new low-shrinkage composite restorative material. Oper Dent 2006;31(6):670-6. 21. Bagis YH, Baltacioglu IH, Kahyaogullari S. Comparing microleakage and the layering methods of silorane-based resin composite in wide Class II MOD cavities. Oper Dent 2009;34(5):578-85.
Conclusion Within the limitation of this study, we conclude that all the restorative systems tested in this study exhibited microleakage. However, silorane based technology (Filtek P90) showed higher microleakage scores compared with the clinically successful methacrylate-based composite materials (Filtek Z250 and Filtek Z250 XT). Acknowledgement We would like to thank Professor Mohammad Al-Omari, Chairman, Restorative Department, RCsDP and King Abdullah International Medical Research Center for providing needed help and assistance during the study. References 1. Craig RG, Powers JM, Wataha JC. Dental Materials Properties and Manipulation, 10th ed. St, Louis: Mosby; 2012. 2. Hickel R, Heidemann D, Staehle HJ, Minnig P, Wilson NH, German Scientific Association for Operative Dentistry, European Federation of Conservative Dentistry. Direct composite restorations: Extended use in anterior and posterior situations. Clin Oral Investig 2004;8(2):43-4. 3. Yazici AR, Celik C, Ozgünaltay G. Microleakage of different resin composite types. Quintessence Int 2004;35(10):790-4. 4. Idriss S, Abduljabbar T, Habib C, Omar R. Factors associated with microleakage in Class II resin composite restorations. Oper Dent 2007;32(1):60-6. 5. Krejci I, Sparr D, Lutz F. A three-sited light curing technique for conventional Class II composite resin restorations. Quintessence Int 1987;18(2):125-31. 6. Weinmann W, Thalacker C, Guggenberger R. Siloranes in dental composites. Dent Mater 2005;21(1):68-74. 7. El-Mowafy O, El-Badrawy W, Eltanty A, Abbasi K, Habib N. Gingival microleakage of Class II resin composite restorations with fiber inserts. Oper Dent 2007;32(3):298-305.
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